We propose to implement and evaluate a community-wide electronic health record to improve health care for inner city children with asthma in New Haven, Connecticut. We have assembled a large group of organizations and enormously talented individuals who are committed to this project and its vision of integrated health care for children in New Haven. This collaboration has enabled us to take on an ambitious set of aims: [unreadable] 1. To implement a shared, community-wide electronic health record for health care providers in pediatric primary care, school health, specialty care, and emergency medicine. The proposed multi-institutional partnership will diminish the obstacles to quality associated with incomplete health records, provide a continuous longitudinal ambulatory record for the majority of New Haven's inner city children with asthma, and allow inter-disciplinary care planning. [unreadable] 2. To demonstrate improvements in quality of care for children with asthma. As a result of improved communication among community partners, we will demonstrate a reduction in communication errors that pose a threat to patient safety. In a second study, we will demonstrate improved asthma care by primary care providers as a result of the implementation of decision support integrated with the electronic health record. [unreadable] 3. To understand organizational barriers and factors that enhance IT acceptance. We will apply an innovative conceptual model based on complex adaptive systems to analyze and interpret the success of the EHR implementation at various sites. [unreadable] 4. To provide administrative and technical elements of a community wide health network infrastructure that can be further extended to additional health partners. [unreadable] [unreadable]